DR. MUTIMBWA JO-ANNE ANAENE (NPI# 1295042125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295042125 |
| Entity Type | Individual |
| Full Name | DR. MUTIMBWA JO-ANNE ANAENE |
| Credential | M.D. |
| Practice Address |
1200 W State St Rockford IL 61102-2112 |
| Practice Telephone | 8154901600 |
| Mailing Telephone | 8154901600 |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2016-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
036132494 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1200 W STATE ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61102-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780680827 | Barbara B Morgan | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2005-06-23 |
| 1588271894 | Angela Siebold | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2020-09-30 |
| 1942814322 | Jacqueline Paige Cabrera | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2020-09-03 |
| 1285250951 | Aaleeyah Pringle Alim | Dentist | 1200 W State St, Rockford, IL 61102-2112 | 2020-06-18 |
| 1639792419 | Jessica Lauren Cole | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2020-05-27 |
| 1437779071 | Christian Murillo | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2020-04-23 |
| 1033746573 | Erin Ashleigh Donahue | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2020-03-25 |
| 1609406008 | Marissa Dreger | Family Medicine | 1200 W State St, Rockford, IL 61102-2112 | 2020-01-24 |
| 1962041657 | Sabrina Lee Puvalowski | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2019-12-30 |
| 1932741717 | Jacob Dalton Boehm | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2019-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205115383 | Renee Lynn Keeney | Advanced Practice Midwife | 1200 W. State Street, Crusader Community Health, Rockford, IL 61102 | 2011-08-08 |
| 1689895906 | Linda Lou O'reilly | Local Education Agency (LEA) | 1515 S. Meridian Road, Rockford, IL 61102 | 2007-05-02 |
| 1801012992 | Jennifer Anne Boyd | Developmental Therapist | Nia 1515 S. Meridian Rd., Rockford, IL 61102 | 2007-04-17 |
| 1609173434 | Kellie J Gibbons | Registered Nurse | 650 W State Street, Winnebago County Jail Medical Unit, Rockford, IL 61102-0000 | 2011-02-14 |
| 1275708752 | Mercy Ambulance Service LLC | Ambulance | 1025 Campton Dr, Rockford, IL 61102-1066 | 2008-04-25 |
| 1417448424 | Brittany Nicole Lambert | Student in an Organized Health Care Education/Training Program | 8040 Towermont Dr, Rockford, IL 61102-1080 | 2018-05-24 |
| 1164490132 | Harlan Johnson | Counselor | 852 Lakewood Dr, Rockford, IL 61102-1228 | 2006-03-08 |
| 1184137283 | Gail Mary Swenson | Speech-Language Pathologist | 730 Lincoln Park Blvd, Rockford, IL 61102-1429 | 2017-11-10 |
| 1659316339 | Institute of Family Care | Home Health | 417 S Pierpont Ave, Rockford, IL 61102-1656 | 2006-06-18 |
| 1861851438 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1200 W State St Ste 102, Rockford, IL 61102-2112 | 2016-02-11 |
| Find all providers in zip 61102 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639265259 | Mohammad Asim Mustafa | Pediatrics | 461 N. Mulford Road, Suite 12, Rockford, IL 61107-5165 | 2006-10-04 |
| 1689848541 | Ignacio Omengan | Pediatrics | 461 N Mulford Rd, Suite #10, Rockford, IL 61107-5190 | 2008-04-22 |
| 1891969796 | Errol C. Baptist M.d. | Pediatrics | 461 N Mulford Rd, Suite 4, Rockford, IL 61107-5190 | 2008-04-22 |
| 1225138142 | Aruna S Shah | Pediatrics | 419 N Mulford Rd, Ste. #1, Rockford, IL 61107-5197 | 2006-09-22 |
| 1043233471 | Errol Christopher Baptist | Pediatrics | 461 N Mulford Rd, Suite # 4, Rockford, IL 61107-5190 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417259979 | Adolescent and Young Adult Place Ltd | Pediatrics | 9 N Cicero Ave, Chicago, IL 60644-3602 | 2010-12-03 |
| 1942520671 | Cherie Priya Dhar | Pediatrics | 1440 N Dayton St Fl 3, Chicago, IL 60642-2644 | 2010-06-04 |
| 1730334764 | Neighborhood Pedicatrics Sc | Pediatrics | 20200 Governors Dr, 101, Olympia Fields, IL 60461-1032 | 2008-11-18 |
| 1790950244 | Kids Place of Willowbrool Sc | Pediatrics | 6727 Kingery Hwy, Willowbrook, IL 60527-5142 | 2008-04-25 |
| 1841475746 | David C. Norman, Md Inc. | Pediatrics | 4600 Memorial Dr Ste G60, Belleville, IL 62226-5366 | 2008-01-09 |
| 1346429859 | Pediatric & Adolescent Center, S.c. | Pediatrics | 125 E Lake Cook Rd Ste 107, Buffalo Grove, IL 60089-4394 | 2007-10-31 |
| 1649475377 | Lisa Kantz Simons | Pediatrics | 225 E Chicago Ave # Ms 161b, Chicago, IL 60611-2991 | 2007-06-21 |
| 1346368487 | Sarah Bush Lincoln Health Center | Pediatrics | 1411 E St, Suite 2, Charleston, IL 61920-2529 | 2007-03-27 |
| 1558402958 | Ashok H Bhaskar | Pediatrics | 2250 Weber Rd, Crest Hill, IL 60435-0928 | 2007-02-09 |
| 1609927417 | Kimberly A Seipel-carrow | Pediatrics | Northwestern University Health Services, 633 Emerson, Evanston, IL 60208-0001 | 2007-01-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.